Complementary Feeding and Growth in Infants Born Preterm: A 12 Months Follow-Up Study.

Giovanni Boscarino,Lucia Dito,Gianluca Terrin,Rita Prota,Elisa Onestà,Maria Giulia Conti,Daniela Regoli,Salvatore Oliva,Giorgia Deli,Chiara Pannucci,Federica Pagano,Maria Di Chiara

doi:10.3390/children8121085

Giovanni Boscarino, Lucia Dito + Show 10 more

Open Access

https://doi.org/10.3390/children8121085

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Journal: Children	Publication Date: Nov 24, 2021
Citations: 2	License type: CC BY 4.0

Affiliation: Policlinico Umberto I, Sapienza University of Rome

Abstract

Evidences demonstrated that timing of weaning influences long-term growth in full term infants. However, studies on preterm infants are still lacking, and the international guidelines are focused only on healthy full-term newborn, without consensus for preterms. We aimed at evaluating, in a cohort study, the consequences of different timing of weaning on auxological outcomes up to 12 months of corrected age in a population of neonates born with gestational age < 32 weeks or birth weight < 1500 g. We divided the enrolled neonates in two cohorts according to the timing of weaning: (i) Early Weaning: introduction of complementary food before 6 months of corrected age; (ii) Late Weaning: complementary food introduced after 6 months of corrected age. Growth parameters (weight, length, body mass index, and ponderal index) were measured at 12 months of life. The two groups were statistically comparable for baseline clinical characteristics, and differences on growth parameters were not reported between the two study groups. These results were confirmed in linear and binary logistic regression multivariate models. Timing of weaning is not related to growth of preterm newborns in the first 12 months of corrected age. Studies are needed to reach consensus for the appropriate nutritional approach for preterm babies after discharge.

Highlights

According to the World Health Organization (WHO), survival of preterm infants has significantly improved thanks to the advances in neonatal care [1]
Morbidity was defined as the presence of at least one of the major prematurity-related complications, such as necrotizing enterocolitis (NEC) Bell-Stage ≥ 2, intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), sepsis proven by positive culture, retinopathy of prematurity (ROP), and bronchopulmonary dysplasia (BPD) of at least moderate grade
Diagnosis of NEC, BPD, IVH, PVL, ROP, and sepsis were performed according to standard criteria by physicians caring for the babies and were blinded of the study aims [22,23,24,25,26]

Summary

Introduction

According to the World Health Organization (WHO), survival of preterm infants has significantly improved thanks to the advances in neonatal care [1]. With the improvement in neonatal survival, preterm birth rates are increasing. It has been demonstrated that there are critical windows for nutritional intervention during the first months of life, which may influence long-term growth. Evidences for healthy, full term infants demonstrated that the timing of starting complementary feeding, known as weaning, influences growth outcomes [8]. International nutritional guidelines recommend exclusive or predominant breastfeeding approximately for the first six months [10,11]. International guidelines are focused mainly on healthy full-term newborn, without consensus for preterms and, with variable clinical attitude among physicians [10,11]

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Conclusion